Melanin Medics and The Racial Disparities In UK Medicine

Melanin Medics is an organisation dedicated to supporting the UK community of African-Caribbean aspiring medics, medical students and medical professionals – while also tackling the underrepresentation of African-Caribbean’s in UK Medicine. Melanin Medics has been focused on implementing practical, effective and positive solutions to help overcome underrepresentation and the multiple socio-economic barriers in the medical profession.

This is not without its challenges: financial challenges; societal challenges; generational and ideological challenges. There are many barriers which stand in the way of a person of African-Caribbean descent becoming a doctor and ascending the ranks. We at Melanin Medics believe there is no barrier which is insurmountable. Despite the various adversities which lie in our paths, we must continue to pursue excellence!

The demographic of the UK has changed greatly over the years, and while African-Caribbean representation in various medical fields has increased, more work is to be done.

This has recently been highlighted by the western world’s enlightened pursuit for greater equality across all domains. The President of the Royal College of Physicians was recently commissioned to examine the 15% gender pay gap among doctors. As part of increasing recognition of the inequality of opportunity in the workplace, attention in the UK is now slowly turning to the ethnicity pay gap. While a discrepancy in ethnic pay across sectors is well-known from previously, it is to be expected that the disparity would disappear for a field as specialised as Medicine. Regrettably that is not the case. Analysis of NHS pay data by Professor John Appleby published in the British Medical Journal (BMJ) recently brought to public attention that white consultants earn on average 4.9% more than their BAME counterparts (amounting to an extra £4644 a year).

It is alarming that such a disparity would be evident at the higher reaches of the NHS (one of the largest employers in the world, of which 20% of its staff in England are from BAME background). Unfortunately the ethnicity pay gap is an issue which can even be seen across territorial borders. In the United States, USA Today found that African-American physicians earn up to 15% less than white physicians.

Of course, there will be those who will attempt to find room for ‘mitigating factors’ on their search for a ‘reasonable explanation’. But this is an issue which needs further investigation. A study by Dr Dan Ly published in the BMJ (Differences in incomes of physicians in the United States by race and sex: observational study (2016; 353)) disappointingly found that ‘these [USA Medicine] income differences remained after adjustment for physician specialty, hours worked, practice characteristics…and geography.’

Dr. Chaand Nagpaul, chair of the British Medical Association (BMA), said of Appleby’s findings “This BMJ study confirms that BAME doctors continue to face unacceptable barriers, penalties and discrimination in the NHS. It cannot be right that in 21st-century Britain there are such wide gaps in pay between white and BAME doctors in senior posts when, irrespective of their background, they hold positions to deliver the same care to patients.”

There are many other issues highlighting racial disparities in general health care which have been raised recently including a study indicating that clinicians show less compassion/empathy for black patients, or less likely to administer painkillers to black children. And there was a recent movement of black medics sharing their experiences of racism and lack of appreciation after a black female surgical registrar was prevented from helping a sick passenger on a plane because flight attendants did not believe she was a medic. It is unfortunate that such disparities appear to have penetrated into the medical profession. And if racial disparities continue, how much real progress can be made to address the imbalance?

It is said that you cannot begin to recover until you accept that there is a problem. And it is evident that many in our medical communities and in society as a whole are blissfully unaware that this ‘ethnicity pay gap’ problem exists. Discrimination at work is a wider societal issue. In many areas of the public sector, steps have been made to have the conversation, so why not in the NHS/in medicine? It is critical that we invite more black medical students and current medics to join the conversation. It is imperative therefore that we increase awareness of the fact that this problem exists – for with more awareness, becomes a greater hunger for change, and a more authoritative united voice calling the powers-that-be accountable to this deficit in the system while simultaneously calling for the change we seek.